{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:43:46Z","timestamp":1785545026752,"version":"3.56.0"},"reference-count":17,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Promoting early HIV testing and patient detection is an important public health goal. In Japan, approximately 30% of the population is diagnosed with AIDS. Several studies have investigated the challenges related to HIV diagnosis; however, there are limitations in understanding the characteristics and barriers faced by individuals who are at high risk of HIV but have not yet been tested or have not sought medical consultation.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to examine the factors associated with medical consultation and HIV-testing behaviors, explore the reasons for not undergoing HIV testing, and evaluate the effectiveness of HIV-related awareness efforts among respondents to a revisit survey conducted via an artificial intelligence (AI)\u2013based symptom search engine.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study used data obtained from the AI-based symptom search engine, Ubie. Episodes involving individuals who used the AI-based symptom checker to search for their symptoms, which were subsequently suggested as HIV\/AIDS\/sexually transmitted infection (STI)\u2013related conditions, were included. Those who answered the first and revisit survey questionnaires were included in the analysis. Multivariable logistic regression analyses were conducted to explore the factors associated with medical consultation in both the overall suggested HIV\/AIDS\/STI\u2013related condition group and the suggested STI-related condition subgroup. Factors associated with HIV testing in individuals who underwent medical consultations were also explored using multivariable logistic regression analysis. The reasons for not undergoing HIV testing and the future intention to undergo testing were described.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The number of eligible episodes was 424,893 for 332,976 individuals. Of these, medical consultations were performed in 105,365 cases and HIV testing in 394 cases. Compared with individuals in their 20s, older age groups were associated with a higher tendency to seek medical consultations. The provision of awareness information through the AI-based symptom checker was associated with medical consultation behavior, and 29% (280\/964) of people who initially had no intention of undergoing HIV testing responded that they would undergo HIV testing after using the AI-based symptom checker. Compared with the internal medicine department, the gynecology department was significantly associated with HIV testing; however, the HIV testing rates were low in the suggested STI-related condition subgroup across major departments.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These results suggest that HIV-related information delivered via an AI-based symptom checker may raise awareness or consideration of medical consultation among individuals actively searching for symptoms potentially associated with HIV. To further promote HIV testing, it may be necessary to refine the content and delivery of educational materials and enhance HIV testing literacy among physicians who encounter patients with STIs.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/90257","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:05:06Z","timestamp":1777417506000},"page":"e90257-e90257","source":"Crossref","is-referenced-by-count":0,"title":["Medical Consultation and HIV Testing After AI-Based Symptom Check: Retrospective Cohort Study"],"prefix":"10.2196","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-1213-0949","authenticated-orcid":false,"given":"Nao","family":"Taguchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2319-9251","authenticated-orcid":false,"given":"Kunihiro","family":"Hirahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6948-2834","authenticated-orcid":false,"given":"Keisuke","family":"Harada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6496-0508","authenticated-orcid":false,"given":"Keisuke","family":"Orimo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4879-8756","authenticated-orcid":false,"given":"KuanYeh","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0330-8262","authenticated-orcid":false,"given":"Kota","family":"Iwahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4198-7503","authenticated-orcid":false,"given":"Akifumi","family":"Imamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"R1","unstructured":"Fact Sheet 2025 Global HIV Statistics. Joint United Nations Programme on HIV\/AIDS (UNAIDS); 2025. URL: https:\/\/www.unaids.org\/sites\/default\/files\/2025-07\/2025_Global_HIV_Factsheet_en.pdf [Accessed 24-09-2025]"},{"key":"R2","unstructured":"The path that ends AIDS: UNAIDS global AIDS update 2023. Joint United Nations Programme on HIV\/AIDS (UNAIDS); 2023. URL: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2023-unaids-global-aids-update_en.pdf [Accessed 24-09-2025]"},{"key":"R3","unstructured":"Global AIDS Strategy 2021\u20132026: end inequalities. End AIDS. Joint United Nations Programme on HIV\/AIDS (UNAIDS); 2021. URL: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/global-AIDS-strategy-2021-2026_en.pdf [Accessed 24-09-2025]"},{"key":"R4","unstructured":"Annual report on AIDS incidence trends in 2025. AIDS Trend Committee, Ministry of Health, Labour and Welfare, Japan; 2026. URL: https:\/\/api-net.jfap.or.jp\/status\/Japan\/nenpo.html [Accessed 24-09-2025]"},{"issue":"2","key":"R5","doi-asserted-by":"publisher","first-page":"e182","DOI":"10.1097\/QAI.0000000000002660","article-title":"HIV testing by public health centers and municipalities and new HIV cases during the COVID-19 pandemic in Japan","volume":"87","author":"Ejima","journal-title":"J Acquir Immune Defic Syndr"},{"issue":"4","key":"R6","doi-asserted-by":"publisher","first-page":"4874","DOI":"10.3934\/mbe.2024215","article-title":"HIV incidence before and during the COVID-19 pandemic in Japan","volume":"21","author":"Nishiura","journal-title":"Math Biosci Eng"},{"issue":"10","key":"R7","doi-asserted-by":"publisher","first-page":"102816","DOI":"10.1016\/j.jiac.2025.102816","article-title":"Missed opportunities: HIV testing deficits among syphilis-tested patients in Japan","volume":"31","author":"Taniguchi","journal-title":"J Infect Chemother"},{"issue":"5","key":"R8","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.26086","article-title":"Association of demographics, HCV co-infection, HIV-1 subtypes and genetic clustering with late HIV diagnosis: a retrospective analysis from the Japanese Drug Resistance HIV-1 Surveillance Network","volume":"26","author":"Otani","journal-title":"J Int AIDS Soc"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"73","DOI":"10.6061\/clinics\/2016(02)04","article-title":"Associations of HIV testing and late diagnosis at a Japanese university hospital","volume":"71","author":"Horino","journal-title":"Clinics (Sao Paulo)"},{"issue":"11","key":"R10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0143874","article-title":"What triggers a diagnosis of HIV infection in the Tokyo metropolitan area? Implications for preventing the spread of HIV infection in Japan","volume":"10","author":"Nishijima","journal-title":"PLoS One"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","first-page":"40","DOI":"10.1016\/j.idm.2024.08.004","article-title":"Regional variations in HIV diagnosis in Japan before and during the COVID-19 pandemic","volume":"10","author":"Nishiura","journal-title":"Infect Dis Model"},{"issue":"4","key":"R12","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s11904-021-00565-y","article-title":"Technology-delivered intervention strategies to bolster HIV testing","volume":"18","author":"Romero","journal-title":"Curr HIV\/AIDS Rep"},{"issue":"9","key":"R13","doi-asserted-by":"publisher","first-page":"2326","DOI":"10.1093\/cid\/ciz1096","article-title":"Machine learning to identify persons at high-risk of human immunodeficiency virus acquisition in rural Kenya and Uganda","volume":"71","author":"Balzer","journal-title":"Clin Infect Dis"},{"key":"R14","unstructured":"Company. Ubie Health. URL: https:\/\/ubiehealth.com\/company [Accessed 24-10-2025]"},{"issue":"3","key":"R15","first-page":"133","volume":"17","author":"Itoda","journal-title":"J AIDS Res"},{"key":"R16","unstructured":"Strategic study for AIDS prevention [Report in Japanese]. Japan Foundation for AIDS Prevention (JFAP); 2002. URL: https:\/\/www.jfap.or.jp\/strategic_study\/hokokuPdf\/01.pdf [Accessed 25-09-2025]"},{"issue":"11","key":"R17","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1177\/09564624221118484","article-title":"HIV testing in a high prevalence urban area in the US: identifying missed opportunities two ways","volume":"33","author":"Anderson","journal-title":"Int J STD AIDS"}],"container-title":["Journal of Medical Internet Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jmir.org\/2026\/1\/e90257","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T22:24:26Z","timestamp":1785536666000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jmir.org\/2026\/1\/e90257"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,18]]},"references-count":17,"URL":"https:\/\/doi.org\/10.2196\/90257","relation":{},"ISSN":["1438-8871"],"issn-type":[{"value":"1438-8871","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,18]]},"article-number":"v28i2e90257"}}